Between 1990 and 2005, 137 patients (83 males, 54 females; median age, 24.2 years; 116 with monocondylar fracture and 21 with bicondylar fracture) were treated with an external fixation system (Mand-X-Fix, Leibinger, Germany). In these cases, the distal fragment was dislocated medially and out of the glenoid cavity (stadium IV of MacLennan).
At the 12-month follow-up, 91 % of treated patients regained their pretrauma occlusion with good functional results (maximum mouth opening: 100 % >30 mm, 81 % >35 mm, 59 % >40 mm; articular pain: <2 % ; clicking: <7 % ) and morphostructural results (fragment overlap significant in 2 % of cases, light in 53 % of cases, and absent in 45 % of cases) and a very low rate of complications in the immediate postsurgical period (temporary paresis of the facial nerve: <7 % ; infection of the surgical wound: <2 % ). No long-term facial palsy was noted.
Our findings indicate that a semirigid fixation technique, represented by the external fixation system, seems to be a better approach to treating condylar fractures with luxation out of the glenoid fossa.